Mistakes are Inevitable: No one is perfect.

Everyone makes mistakes, absolutely everyone. There is no such thing as a perfect person, and since all nursing students, CNAs, LPNSs, RNs, and providers are human, there are no perfect nursing students, CNAs, nurses or providers. Nursing school doesn't really teach you to be a nurse; it just gives you a glimpse into the world of nursing. The NCLEX merely gives you a license to learn. If you're smart, you will learn something new every day of your career, and if you're very very smart, you'll learn how to handle those moments when you've been very, very stupid. Read More

Requiring Bedside Experience for NP

There are quite a few NP programs without requiring bedside RN experience for admission. I think this should be mandatory, especially for online programs that admit 100,000 students every semester. I really wish advanced nursing programs were more standardized in a national basis. I wonder if this was ever a topic when formulating the Consensus Model... Read More

[Toon] Has anyone ever caught you in the act??

Are you constantly checking out your neighbor's veins? How about when you are out shopping or on a vacation? Or, when viewing your favorite TV show? It's happened to quite a few people. Has anyone ever caught you in the act?? Read More

What questions should I expect in my ICU interview?

I am an experienced med-surg tele RN of almost 4 years - I'm curious what types of questions to expect in an ICU interview. Most of the threads have been for new grad internships and such, so I'm interested in knowing what differs. Read More

Sepsis + Antibiotics = Severe Hypotension?

Someone had posted some info on this a while ago but I can't seem to find it. But isn't there a correlation with IV antibiotics initiation and a systemic vasodilation response?

Pt presents looking pretty terrible, maybe urosepsis or some other infection.... Pt is hypotensive or borderline. Probably getting fluid boluses. Once antibiotics are initiated, patient basically craps out. BP down the drain. Ends up on pressors if they make it that far. I thought I had read something about the bacteria causing mass vasodilation in response to antibiotic therapy. Can anyone touch upon this? Read More

Why I Cannot Sleep

When patient neglect becomes so appalling, so gut-wrenching, what do you do? How do you make it up to a patient whose existence has become no less than a horror movie? I don't know about you, but I'm not interested in thickening my skin any more.

I need to talk about my patient today. My days in the hospital are frequently hard and heartbreaking, but nothing I haven't learned to shake off by the time I walk through my front door. Occasionally, I need a good cry on the drive home, but it's cathartic. I may hear monitor alarms in my sleep, but I don't see my patients. Read More

Unifying the Advanced Practice Roles

Although the APRN roles are distinct in their own right, this shouldn't mean that Advanced Practice should be fragmented as well. I want to suggest why not rename all the APRN roles, CRNA, NP, CNM and CNS into one singular term, Nurse Practitioner.

NP is already very well known to the public. I think this would not only lessen confusion but improve the public image of Advanced Nursing. It would also unify all the roles, just like every other health profession. Why keep the alphabet soup in our profession? Read More

Visitors/family with bad odors

Any advice on dealing with a dad who comes into the NICU reeking of cigarette smoke and ody odor to sit next to his kid? Its enough to make us gag and the other moms don't appreciate it (neither do the babies, I'm sure). Read More

Centimeters Away From Brain Death

A normal day as a nurse can include life leaving someone's body. Have you ever stopped to think about that? It's Tuesday, you're pulling your scrubs over your head and putting your badge on.. and little do you know, in 4 hours you'll be the last person someone sees before they are ushered into the afterlife. And that's just Tuesday. The things we do on a daily basis still astound me, 4 years into my career. I can't believe I get to do this. When the reality of my work hits me in between blood draws, hanging antibiotics, calling doctors for doctors, and emergent intubations.. it really punches me in the face. And the last time, it was almost a knockout. Read More

Chest pain protocol

I am wondering how your Ed treats chest pain. We get EKG in 15 mins, start IV give IV nitroglycerin, Zofran, Ativan, Dilaudid.5, Asa, and Plavix and chest X-ray and cardiac panel. What are your guys orders like? Read More

What was your last job prior to ICU?

I've gleaned information on this topic from various threads, but was looking for some more input. I am an RN of three years (LPN for 5) with experience in skilled nursing, home health, and LTC. Presently I am trying to get a foot in the door of a hospital, realistically feeling this will greatly improve my chances of landing an ICU job in the future. So what were you doing prior to working in the unit and how difficult was it to land said job? Read More